Metastatic placental site trophoblastic tumor: long-term remission in a patient treated with EMA/CO chemotherapy.
OBJECTIVE
We document a case of long-term remission in a patient with metastatic placental site trophoblastic tumor (PSTT) and attempt to determine the response rate of metastatic PSTT to EMA/CO (etoposide, methotrexate, actinomycin-D, cyclophosphamide, and vincristine) combination chemotherapy based on available reports.


METHODS
Medical records, histological slides, and radiological films were reviewed for a patient with metastatic PSTT diagnosed in 1991. Using Medline and cross-references, pertinent articles were reviewed.


RESULTS
A 31-year-old patient with PSTT metastatic to the lungs and vagina is presently alive, without evidence of recurrent cancer, more than 6 years after treatment with EMA/CO chemotherapy and surgery. The total response rate for seven patients with metastatic PSTT treated with EMA/CO chemotherapy was 71% with a complete response rate of 28%.


CONCLUSIONS
Metastatic PSTT is potentially curable. EMA/CO chemotherapy appears superior to older multiagent regimens used in treating PSTT.
Swisher
E
E
Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Drescher
C W
CW
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011859:Radiography; D012074:Remission Induction; D018245:Trophoblastic Tumor, Placental Site / Q000188:drug therapy* / Q000473:pathology; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014625:Vaginal Neoplasms / Q000556:secondary; D014750:Vincristine / Q000008:administration & dosage
D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate